Fairview Comfort Home

Type of visit: Case Management - Annual Continuation

At approximately 10:00 AM Licensing Program Analyst (LPA) Star Stevenson arrived to CONTINUE a required 1-year annual inspection and was greeted by Licensee Administrator Patricia Harland. At approximately 10:10 AM LPA toured upper staff rooms and noted all staff rooms now had locking handles to reduce the risk of potential theft by visitors or other staff and to limit access to potential staff medicines. At approximately 10:25 AM , LPA reviewed three (3) staff files and five (5) resident files. Licensee was advised that S1, although had TB clearance, continues to need a full health/MD health screening (physical) LPA reviewed five (5) of 5 resident files and advised licensee of the need to get R1 and updated Physician's Report LIC602 report and asked to send copy of updated LIC602 to Community Care Licensing (CCL) (technical violation issued) Licensee/Administrator coordinates medical and dental visits for the residents and uses a third party transportation company to take them to their appointments. At approximately 12:10 PM, LPA reviewed medications and medication records which are maintained and stored in compliance with regulation. Facility does not manage P&I monies. Updated copies of the following documents are to be submitted to CCL within 30 days of this visit: LIC500 - Personnel Report (updated) Techinical Violations and advisories are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Appeal rights were given. Exit interview conducted with Licensee whose signature on form confirms receipt.the state’s words, verbatim · CDSS document, Oct 2, 2025

The state marks this report as 4 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

At approximately 12:25 PM, Licensing Program Analyst (LPA) Star Stevenson arrived unannounced to BEGIN a required 1-year annual inspection and was greeted by Administrator Patricia Harland. Facility is a Residential Care Facility for the Elderly (RCFE) with six (6) residents in care. All residents were present during today's inspection. Facility has a hospice waiver for four (4), clearance for one (1) bedridden resident. Facility currently has two (2) Hospice residents in care, and is approved for all non-ambulatory residents. At 12:40 PM, LPA observed that facility had removed a door stop at the automatically closing door between living room and bedroom #1 as required by recent fire safety inspection performed to allow care for a bedridden resident. At approximately 12:45 PM, LPA continued a tour of the facility with administrator and observed the following: Facility is a two story home with residents only living on the ground floor, was a comfortable temperature, and passageways were free from obstructions. Facility is noted to now have evacuation chair at top of the stairs. Water temperatures in Residents' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, paper products, and incontinent care briefs available to residents. Residents' bedrooms were inspected and observed to have appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Several staff members were observed to struggle to unlock/use the under-the-sink lock where knives and toxins are stored in the kitchen and a technical advisory was issued for the facility to attain an easier/safe locking mechanism. In addition a staff room upstairs was noted to need a lock, in case staff had prescription medicines or valuables and administrator was advised to attain an easy to use door knob lock (such as popular touch pad combo locks) to ensure future safety and security from theft for residents and mobile visitors. Hallway pull-down attic stairs were climbed for LPA to observe additional storage with Christmas decorations and supplies etc. Continued on LIC809-C... Continued from LIC809 Facility has at least two days of perishable food and one week of non-perishable foods, as well as an emergency water supply. Administrator was advised to ensure all staff and resident foods that are taken out of their original commercial packages are labeled with the date they are put into zip-lock bags or Tupperware for refrigeration and Technical Advisory issued. Medications were centrally stored and locked. Facility does not handle resident money. There is a covered seating area and gazebo in the backyard with outdoor space and bar-b-que for activities. Facility has an internet access device available for resident use. In addition, facility has a large hard-wired gas powered emergency generator. Facility has internet available to residents in care and the phone was tested an operational. LPA obtained a copy of the facility's updated infection control plan and emergency disaster plan which was last updated July 2025. LPA observed a supply of PPE, emergency supplies, a first aid kit, and flashlights. Administrator was advised of the need to update the recently expired "Statement of Information" (SOI) for Har Lee Mar Worldlink Corporation with the Secretary of State office. LPA obtained the following for the facility file: 1)Updated Liability Insurance 2)LIC500 Personnel Report 3)LIC9020 Register of Facility Residents 4)LIC610E Updated emergency disaster plan 5)LIC308 Designation of Facility Responsibilty for two (2) new employees. 6)LIC9282 Updated infection control plan Technical advisories were cited from cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. No deficiencies cited today LPA will return at a later date to perform staff and resident file review and medicine administration review. This report was reviewed with Patricia Harland and Appeal rights were given.the state’s words, verbatim · CDSS document, Sep 10, 2025

The state marks this report as 9 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

At approximately 10:10 AM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a required 1-year annual inspection and was greeted by Rosalie Cocson, Designated Responsible Party (RP). Patricia Harland, LIcensee/Administrator was contacted and arrived at approximately 10:45 AM. Facility is a Residential Care Facility for the Elderly (RCFE) with six (6) residents in care. All residents were present during today's inspection. Facility has a hospice waiver for four (4), has two (2) Hospice residents currently in care, and is approved for all non-ambulatory residents. At approximately 10:30 AM, LPA initiated a tour of the facility with RP and observed the following: Facility is a two story home, was a comfortable temperature, and passageways were free from obstructions. Licensee provided proof that an evacuation chair has been ordered for the facility. Water temperatures in Residents' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, paper products, and incontinent care briefs available to residents. Residents' bedrooms were inspected and observed to have appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. LPA advised House Manager and Licensee to ensure all such items are secured and inaccessible to residents when not being used. Facility has at least two days of perishable food and one week of non-perishable foods, as well as an emergency water supply. Medications were centrally stored and locked. There is a covered seating area in the backyard with outdoor space for activities. Facility has an internet access device available for resident use. Facility has internet available to residents in care and the phone was tested an operational. Facility's fire extinguisher was observed charged and was last serviced December 2023. Smoke and Carbon Monoxide detectors were tested and operational during inspection. Facility conducts quarterly disaster drills with the most recent drill was conducted August 2024. Continued on LIC809-C... Continued from LIC809... LPA observed facility's infection control plan and emergency disaster plan which was last updated April 2024. LPA observed a supply of PPE, emergency supplies, a first aid kit, flashlights and a back up generator for emergency preparedness. Licensee provided LPA with a copy of the facility's current liability insurance. At approximately 12:00 PM, LPA reviewed three (3) staff files and six (6) resident files. Facility currently has four (4) staff but Licensee was only able to provide LPA with three (3) staff files for review (See LIC809D). Three (3) of three (3) staff files reviewed have the required paperwork and proof of current First Aid and CPR training. However, Licensee was unable to provide proof of annual medication training for two staff (See LIC809D). LPA advised Licensee to ensure proof of all staff initial, annual, and medication training is available for review upon request by Licensing. LPA also advised Licensee to ensure compliance with all initial training requirements for all new staff. Six (6) of six (6) resident files reviewed have all the required paperwork. Licensee/Administrator coordinates medical and dental visits for the residents and uses a third party transportation company to take them to their appointments. At approximately 3:30 PM, LPA reviewed medications and medication records which are maintained and stored in compliance with regulation. LPA advised Licensee to ensure staff are documenting medication parameters and adherence to them. Facility does not manage P&I monies. Updated copies of the following documents are to be submitted to CCL within 30 days of this visit: LIC500 - Personnel Report (updated) Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Appeal rights were given. Exit interview conducted with Licensee whose signature on form confirms receipt.the state’s words, verbatim · CDSS document, Oct 4, 2024

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Carol Fowler conducted a Required- 1 Year visit, on 10/06/2023 at approximately 1:15am, and met with Patricia Harland, Administrator. Certificate, #6011678740, is current- expires 01/08/2024. LPA observed two caregivers working at the time of arrival. There are currently five (5) residents in care. Facility has a required infection control plan. Facility has an emergency disaster plan as required. The facility conducted a fire drill and an earthquake emergency drill on 9/15/2023. The facility does have emergency food and supplies to meet the "72 hour shelter in place" requirements. All exits were free and clear of obstruction. Fire extinguisher, was last serviced on 12/9/2022 and tagged as required. LPA observed ten (10) smoke alarms and one (1) carbon monoxide detector, working properly during the inspection. Facility was found to be clean, orderly, and at a comfortable temperature. Hot water was checked at 107.0 F, which is within regulation. Medications were stored and locked making them inaccessible to residents. There was a sufficient supply of hygiene products, cleaning supplies, and paper products for use as needed. All bathrooms had grab bars, and non-slip mat/flooring for bathing/showering as needed. Facility has a sufficient supply of personal protective equipment(PPE) for use as needed. LPA observed sufficient supply of food, perishable and non-perishable for residents in care. Continue on LIC809C Continue from LIC809 There are currently five (5) residents in care. LPA reviewed three (3) of five (5) resident files; All resident files were found to be complete. LPA reviewed three (3) staff files. LPA reviewed staff training. All three (3) staff have criminal record clearance, and are associated as required. All staff had required annual training. All staff had current First Aid and CPR Certification. LPA is requesting the following documents be updated and submitted by 10/16/2023: LIC308 - Designation of Administrator Responsibility LIC500 - Personnel Report LIC610E-Emergency Disaster Plan (ensure to provide all information in all boxes as required) Infection Control Plan Control of property Copy of Current Liability Insurance Copy of current Administrator Certificate No deficiencies cited during inspection. Exit interview conducted with the Administrator. Copy of this report providedthe state’s words, verbatim · CDSS document, Oct 6, 2023